How does this medication work? What will it do for me?

Rabies vaccine belongs to the class of medications called vaccines. It is used to preventrabies virus infection after being exposed to the virus. It may also be used to prevent rabies infection before being exposed to the rabies virus, for people who are at a high risk of being exposed to rabies due to their work (i.e., veterinarians), travel, or hobbies.

This vaccine increases your defenses against the rabies virus by stimulating the production of your own antibodies, which will remain in the body until needed to fight off any future rabies virus you are exposed to. Antibodies usually develop within 7 to 14 days after being immunized.

Your doctor may have suggested this vaccine for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are receiving this vaccine, speak to your doctor.

How should I use this medication?

If you are receiving the rabies vaccine before being exposed to rabies, 3 doses are needed. The usual dose of this vaccine is 1 mL given as an intramuscular (into the muscle) injection into the outer upper arm (or thigh in children less than 1 year of age). The first dose is given on the initial visit, the second dose is given 7 days later and the third dose is given 3 weeks after the first dose.

It is very important to receive these vaccinations on schedule, as cases of rabies have been report when this schedule was not followed.

If you are receiving this vaccine because you have been exposed to rabies, a series of 5 doses will be given. The first dose should be given as an intramuscular injection as soon as possible after exposure. The second dose is given 3 days later, the third dose is given 7 days after the first; the fourth dose is given 14 days after the first dose and the final dose is given 28 days after the first dose.

A dose of rabies immune globulin will also be given as soon as possible after exposure to the rabies virus.

If you are receiving this vaccine because you have been exposed to rabies, and you were previously vaccinated, a series of 2 doses will be given. The first dose should be given as an intramuscular injection as soon as possible after exposure. The second dose is given 3 days later.

This vaccine is given by a health care professional in a doctor's office, hospital, or clinic.

It is important this medication be given exactly as recommended by your doctor. If you miss an appointment to receive rabies vaccine, contact your doctor as soon as possible to reschedule your appointment.

This medication is stored in the refrigerator and should not be allowed to freeze.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

If you are receiving this vaccine for pre-exposure prevention, do not take this medication if you are allergic to the rabies vaccine or any other ingredients of the vaccine.

Because infection with the rabies virus is almost inevitably deadly if not treated with the vaccine, everyone who comes into contact with the rabies virus should be vaccinated.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

abdominal pain

dizziness

flu-like illness

headache

muscle aches

nausea

pain, redness, and swelling or itching at the injection site

tiredness

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

fever

hives

joint pain

lymph node swelling

skin rash

Seek immediate medical attention if any of the following occur:

signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Bleeding disorders: If you have a bleeding disorder or are taking medications that make you more likely to bleed (i.e., warfarin, acetylsalicylic acid [ASA]) tell the person giving you the injection. There is a risk of excessive bleeding where you get the injection if it is not done carefully.

Allergic reactions: As with any vaccine, allergic reactions are possible with the rabies vaccine. Your doctor may want you to remain in the clinic or office for a period of time after receiving the vaccine, to ensure that you do not develop an allergic reaction.

Immune system: As with any vaccine, this vaccine may not be as effective for people with a weakened immune system (e.g., people with AIDS or cancer, people taking antirejection medications after an organ transplant, people receiving chemotherapy, people taking any medication that suppresses the immune system). Your doctor may want to do blood tests to check how well your body has responded to the vaccine.

Vaccine protection: As with any vaccine, this vaccine may not protect 100% of people who receive it and may not prevent infection in those people already infected with virus.

Pregnancy: If there is a significant risk of contact with rabies, women should consider receiving vaccination before pregnancy. Infection with the rabies virus is frequently fatal if vaccination is not started as soon as possible after contact with the virus. For this reason, the benefits of receiving the rabies vaccine while pregnant outweigh the risks to the mother and developing baby.

Breast-feeding: It is not known if rabies vaccine passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Because infection with the rabies virus is often fatal, vaccination should not be postponed if it is needed. Talk to your doctor about whether you should continue breast-feeding.

What other drugs could interact with this medication?

There may be an interaction between rabies vaccine and any of the following:

acetaminophen

belimumab

chloroquine

fingolimod

immunosuppressants (medications used to treat cancer or autoimmune disease, or prevent organ rejection)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

stop taking one of the medications,

change one of the medications to another,

change how you are taking one or both of the medications, or

leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.